| Objective:Through the study of P16 and Ki67 in cervical condyloma acuminatum and cervical intraepithelial neoplasia in expression, we went to analyze their clinical significance, and to investigate the differential diagnosis between the cervical condyloma acuminatum and the cervical intraepithelial neoplasia.Methods:From January 1 2013 to December 31 2013,in liaocheng people’s hospital after cervical biopsy or LEEP.CIN patients set of 558 cases of cervical tissue by pathologic diagnosis, selected maximum age 78 years old, minimum 22 years old; cervical condyloma acuminatum set of 129 cases of cervical tissue by pathologic diagnosis, selected maximum age 78 years old, minimum 22 years old; Selection of hysteromyoma, uterine prolapse or muscle adenopathy whole hysterectomy,96 cases of normal cervical or cervicitis tissues as control group, having no obvious difference between the two groups in age.592 patients in outpatient service of department of gynaecology microscopic biopsy or LEEP by colposcope All specimens were fixed by 10% formalin, conventional paraffin embedding, three um serial section. For the statistical analysis using SPSS 13.0 statistical software package processing, for this rate to compare the overall inspection discriminating between two groups compares the four table chi-square test, correlation analysis using cross table associated with r analysis.Results:1. P16 expression in cervical condyloma acuminatum:normal skin cervical condyloma acuminatum (9.09%)’, cervical condyloma acuminatum with low-level CIN(82.35%)2,cervical condyloma acuminatum with high-grade CIN(98.41%)3, cervical condyloma acuminatum mergered of cervical cancer(100%)4,respectively compared,P16 expression differences(①②)P<0.01, ②③)P<0.01, ②④<0.01),there are statistically significant; The positive rate of P16 in normal cervical tissue or cervicitis was 0%; P16 expression in cervical intraepithelial neoplasia:P16-positive rate in the low-level and high-grade CIN, respectively:57.69%,85.80%, Weakly positive rate:39.74%,7.10%, Moderately positive rate:12.82%,17.59%, Strong positive rate:5.13%,61.11%.P16 in simple low level and low level hollowed out samples group, P< 0.01, statistically significant; P16 in pure high grade CIN and high grade CIN tired gland, pure high-grade CIN and high grade CIN tired gland hollowed out samples, P< 0.05, statistically significant.2. Ki67 expression in cervical condyloma acuminatum:normal skin cervical condyloma acuminatum(36.36%)1,cervical condyloma acuminatum with low-level CIN(76.47%) 2,cervical condyloma acuminatum with high-grade CIN(98.41%) 3,cervical condyloma acuminatum mergered of cervical cancer(100%) 4 respectively compared,Ki67 expression differences(②③P<0.05,②③)P<0.01, ①③P<0.01,②④<0.05), there are statistically significant. Ki67 expression in cervical intraepithelial neoplasia:Ki67-positive rate in the low-level and high-grade CIN, respectively:79.49%,87.04%,Weakly positive rate:16.23%,5.86%, Moderately positive rate:58.12%,21.3%,Strong positive rate:5.14%,59.88%.Ki67 in simple low level and low-level hollowed out samples group,P<0.05,statistically significant;Ki67 in the pure high-grade CIN and high-grade hollowed-out CIN tired glands (P<0.05) statistically significant.3.The positive rate of P16 in the control group, cervical condyloma acuminatum group and cervical intraepithelial neoplasia group, respectively:0.00%,84.50%,74.04%, each in the two groups by four tables to test,P16 expression were differences (P<0.01, P <0.01, P<0.05), which were statistically significant.Ki67-positive rate in the control group, cervical condyloma acuminatum group and cervical intraepithelial neoplasia group, respectively:8.33%,84.5%,83.87%; Ki67 in the control group and cervical condyloma acuminatum group (P< 0.01), the control groupand cervical intraepithelial neoplasia group (P< 0.01), the difference was statistically significant. P16 and Ki67 in cervical condyloma acuminatum and intraepithelial neoplasia is highly positive correlation (r 0.704,r=0.685).4. The accuracy of colposcope,which in cervicitis, cervical condyloma acuminatum with low level of CIN,cervical condyloma acuminatum with high level of CIN, cervical condyloma acuminatum with cervical cancer, low level CIN and high grade CIN, respectively:71.19%,73.68%,77.28%,70.74%,77.28%, early acuteness wet wart is easy confusion with squamous epithelial verrucous hyperplasia, pseudo condyloma want, which can be identified by histological examination with immunohistochemical P16, Ki67.5.The positive rate of P16 in simple low-level CIN, hollowing out low-level CIN, cervical condyloma acuminatum with low-level CIN, respectively:34.95%,75.57%, 82.35%; Ki67 in their positive rate were 72.82%,84.73%,76.47%. The positive rate of P16 in pure high grade CIN, hollowing out high grade CIN, CCA with high grade CIN, respectively,85.77%,85.92%,98.41%; Ki67 in their positive rate respectively:85.37%, 90.14%,98.41%.Conclusion:1.P16 in cervical condyloma tissues with low expression, such as increased expression, indicates that cervical condyloma acuminatum has a tendency to cancer;P16 in normal cervical tissue or cervicitis not expressed, in the low level intraepithelial neoplasia weakly positive expression, in the high-grade intraepithelial neoplasia strong positive expression, in a hollowed out high grade tired gland on layout all expression; P16 can early detection of cervical lesions and auxiliary diagnosis of cervical intraepithelial neoplasia grade, We should pay attention to high levels of hollowing out sample cells tired gland.2.1f Ki67 expressed in cervical condyloma acuminatum tissues increased,It prompt cervicalcondyloma acuminatum has a tendency to become cancerous. The expression of Ki67 in cervical intraepithelial neoplasia:As the level increases, the intensity of expression gradually increased,more high-grade tired gland strongly positive rate,Ki67 could predict the severity of cervical lesions.3. P16 and Ki67 can be used as identify biomarkers,which in normal cervical tissue, cervical condyloma acuminatum and intraepithelial neoplasia. P16 and Ki67 consistent in their diagnosis, statistically positive significant.4.Colposcopy can distinguish most of the normal cervical tissue, cervical condyloma acuminatum and intraepithelial neoplasia, It has important value in the diagnosis and classification of early cervical lesions. It improve the clinical diagnosis rate,which Suspicious areas of biopsy under colposcopy combined immunohistochemical P16 and Ki67 detection, It is worth popularizing widely.5. When the cervical intraepithelial neoplasia merger acuteness wet wart or hollowed sample cell, P16, Ki67 expression enhanced obviously; P16 and Ki67 may be used as a testing index of HPV infection; The cervical condyloma acuminatum and intraepithelial neoplasia is closely related. |
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